Several studies demonstrated that the presence of occult micrometastases in bone marrow or peripheral blood (one cancer cell in one million "normal" cells) is predictive of a poor clinical outcome in patients with solid malignancies. Consequently, the ability to detect disseminated tumor cells at diagnosis and during therapy is essential for the optimal care of the oncology patient. Microscopical analysis based on immunocytochemistry using anti- cytokeratin antibodies is currently regarded as benchmark method for micrometastases detection. However, analysis cell numbers of 107 to 108 for the presence of cancer cells as a laborious task. In this project we will develop a fully automated Rare Event Localizer (REL) that can analyze 107 cells for the presence of cancer cells in less than 30 minutes. The core of the REL is a high-gain CCD camera, that covers large microscopic fields, and thus the need for time consuming scanning is eliminated. Our fluorescence based system will allow the detection of multiple markers at a single cell level. We will validate the performance of the REL by analyzing normal blood samples, seeded with cancer cells, and cancer patients' samples. We will also develop protocols for multiple marker analysis in breast, lung and prostate cancer. PROPOSED COMMERCIAL APPLICATIONS: Single Pixel Biomedical, Inc. is developing a blood tet for early detection, prognostic profiling and therapy monitoring of cancer patients. The test will be offered to high risk populations for cancer screening, and to newly diagnosed patients for prognosis evaluation assessment and guidance for optimal therapy. Additionally, the test can be offered to pharmaceutical companies for instant evaluation of the effects of new treatments.